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患者：女性，28岁，未婚。双手掌指关节，近端指间关节疼痛伴月经量增多2年。院查RF(+)，拟类风湿关节炎，治疗效果不佳。查体：面色苍白，水肿，浅表淋巴结不肿大，心肺(-)，肝脾(-)。双手小关节活动无障碍，无畸形，指端可见红斑，WBC3.2×10/L，Hb6.5g/LPLT54×10/L，网10%，尿常规RBC5～8/HP，Pro(++)，手X线片未见异常。最可能的诊断是什么（ ）|患者，男性，42岁。双颞颌关节、腕关节、膝关节对称性肿痛伴晨僵3个月，RF(+)，ESR34mm/h，CRP56mg/dl，手X线片示骨质疏松。诊断是（ ） A. 风湿性关节炎 B. 类风湿关节炎 C. 系统性红斑狼疮 D. 干燥综合征 E. 性脊柱炎
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